甲胎蛋白、亮氨酸氨基肽酶和α L聚焦酶在原发性肝癌中的诊断价值

中国综合临床 Pub Date : 2020-03-01 DOI:10.3760/CMA.J.ISSN.1008-6315.2020.02.003

Zhi-ping Guo

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引用次数: 0

摘要

目的探讨中性粒细胞明胶酶相关脂质载体蛋白（NGAL）、甲胎蛋白（AFP）、亮氨酸氨基肽酶（LAP）、α-L-岩藻糖苷酶（AFU）在原发性癌症（PHC）中的单独检测和联合检测，探讨其对癌症的诊断价值。方法选择云南省第三人民医院2015年1月至2017年12月收治的原发性肝癌患者124例为PHC组，同期治疗的肝硬化患者53例为良性A组，肝囊肿患者37例为良性B组，健康志愿者64例为健康组。分别用速率法、免疫比浊法和电化学发光法检测四组受试者血清AFU、LAP、NGAL和AFP。采用受试者工作特性曲线（ROC）分析不同指标组合对PHC的诊断效果。结果PHC组、良性A组、B组和健康组血清AFP、AFU、LAP水平及阳性表达率差异有统计学意义（F值分别为56.832、38.209、23.415；χ2值分别为69.324、72.568、24.695；均P<0.05），PHC组LAP水平和阳性表达率均显著高于良性A组、B组和健康组，差异有统计学意义（均P<0.05）；AFP+AFU+LAP联合检测的敏感性（89.27%对72.17%、73.52%、76.31%、81.35%、80.69%、86.87%）、特异性（95.76%对81.58%、82.79%、84.16%、86.95%、94.23%、93.29%）和约登指数（0.85和0.54、0.56、0.60、0.68、0.75、0.80）优于其一项指标（LAP、AFU、AFP）和两项指标联合检测（LAP+AFU、LAP+AFP、AFU+AFP）。ROC曲线分析显示，AFP+AFU+LAP联合检测的AUC（0.94）大于LAP+AFU（0.78）、LAP+AFP（0.85）和AFU+AFP（0.89）。关键词：原发性癌症；脂质载体蛋白；甲胎蛋白；亮氨酸氨肽酶；α-L-岩藻糖苷酶；诊断

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Diagnostic value of alpha fetoprotein, leucine aminopeptidase and α L fucosidase in primary liver cancer

Objective To investigate the detection of neutrophil gelatinase related lipid carrier protein (NGAL), alpha fetoprotein (AFP), leucine aminopeptidase (LAP), alpha L fucosidase (AFU) in primary liver cancer (PHC) individually and jointly The diagnostic value of cancer (PHC). Methods From January 2015 to December 2017, 124 patients with primary liver cancer from the third people′s Hospital of Yunnan Province were selected as PHC group, 53 patients with cirrhosis treated at the same time as benign group A, 37 patients with liver cyst as benign group B, and 64 healthy volunteers as healthy group. The serum AFU, LAP, NGAL and AFP of four groups of subjects were detected by rate method, immunoturbidimetric method and electrochemiluminescence method respectively. The diagnostic efficacy of PHC detected by different combinations of indicators was analyzed by receiver operating characteristic curve (ROC). Results There were significant differences in serum AFP, AFU, LAP levels and positive expression rates between PHC group, benign group A, group B and healthy group(F values were 56.832, 38.209, 23.415, respectively; χ2 values were 69.324, 72.568, 24.695, respectively; all P<0.05), and the serum AFP, AFU, LAP levels and positive expression rate were significantly higher in the PHC group than in the benign group A, group B and healthy group, the difference was statistically significant( all P<0.05); sensitivity of AFP+ AFU+ LAP combined detection(89.27% vs.72.17%, 73.52%, 76.31%, 81.35%, 80.69%, 86.87%), specificity(95.76% vs.81.58%, 82.79%, 84.16%, 86.95%, 94.23%, 93.29%) and the Yoden index (0.85 and 0.54, 0.56, 0.60, 0.68, 0.75, 0.80) are superior to their one indicator (LAP, AFU, AFP) and two indexes combined detection(LAP+ AFU, LAP+ AFP, AFU+ AFP). ROC curve analysis showed that the AUC(0.94) combined with AFP+ AFU+ LAP was greater than LAP+ AFU(0.78), LAP+ AFP(0.85) and AFU+ AFP(0.89). Conclusion Combined detection of AFP, AFU and LAP can effectively improve the diagnosis efficiency of PHC and reduce missed diagnosis. Key words: Primary hepatic cancer; Lipid carrier protein; Alpha fetoprotein; Leucine aminopeptidase; α-L-Fucosidase; Diagnosis

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来源期刊

中国综合临床

CiteScore

0.10

自引率

0.00%

发文量

16855

期刊介绍： Clinical Medicine of China is an academic journal organized by the Chinese Medical Association (CMA), which mainly publishes original research papers, reviews and commentaries in the field. Clinical Medicine of China is a source journal of Peking University (2000 and 2004 editions), a core journal of Chinese science and technology, an academic journal of RCCSE China Core (Extended Edition), and has been published in Chemical Abstracts of the United States (CA), Abstracts Journal of Russia (AJ), Chinese Core Journals (Selection) Database, Chinese Science and Technology Materials Directory, Wanfang Database, China Academic Journal Database, JST Japan Science and Technology Agency Database (Japanese) (2018) and other databases.